Abstract 2470: Severe Patient-prosthesis Mismatch Does Not Impair Quality Or Life Or Left Ventricular Mass Regression One-year Following Aortic Valve Replacement.
Objectives Patient-prosthesis mismatch (PPM) following aortic valve replacement (AVR) has been associated with an increase in mortality. Presumably, this results from the adverse hemodynamic consequences resulting from an inferior cross-sectional area for transvalvular flow. There is currently minimal data on how PPM influences left ventricular mass (LVM) regression, symptom status or quality of life. Our aim was to determine the impact of PPM on these variables 1-year post-operatively.
Methods 161 patients who required AVR for aortic stenosis participated in a randomized controlled trial comparing stentless and stented bioprostheses. Transthoracic echocardiography was undertaken in 145 surviving patients to measure LVM regression 1-year post-operatively. Severe PPM was defined as an effective orifice area index (EOAI) <<26> 0.65 cm2/m2. QOL was assessed using the SF36 and CRIQ health questionnaires which tested physical, emotional and mental health. Symptoms were evaluated using NYHA functional status.
Results One-year post-operatively severe PPM was observed in 21% (31/145) of patients. Pre-operative baseline demographics of the two groups were not significantly different. LVM regression, symptom status and QOL of life were not found to be impaired in patients with severe PPM (Table 1⇓).
Conclusions Despite a significantly reduced EOAI, LVM regression was not impaired in patients with PPM. QOL, as assessed by two health questionnaires, was also not found to be worse in this group of patients. Approximately 80% of patients in both groups were in NYHA class I. Severe PPM was not associated with any adverse clinical outcomes 1-year following AVR.